Tuesday, June 04, 2013

The Evidence That The NEHRS / PCEHR Is Not Fit For Purpose Seems To Be Building.

The following appeared a few days in the Pharmacy News.

Pharmacy linked to PCEHR problem

28 May, 2013 Nick O'Donoghue
A community pharmacy is believed to be the source of an error in a journalist’s Personally Controlled Electronic Health Record (PCEHR).
Kate McDonald, a reporter with Pulse+ IT, revealed that she had discovered two prescriptions, for conditions she did not have, had been erroneously added to her PCEHR.
“The prescriptions were written on 12 March 2012, and came with a number of repeats for each drug,” she said.
“Two of those repeats scripts were dispensed from my local pharmacy on 4 January 2013, and the details then found their way onto the PBS section of my PCEHR in February, although there were no corresponding MBS items on my record showing that a consultation had taken place.”
After initially publishing an article highlighting the error, Ms McDonald said she was contacted by the Department of Human Services (DHS), who conducted an investigation, which revealed that the scripts had been dispensed from her regular pharmacy.
More here:
This report follows mentions I have made on the blog with a range of anomalies in the state of my record - duplication and missing data - and the apparently random changes in my name over the last 12 months or so.
I am also hearing that we two are not the only ones who have noticed anomalies and inconsistencies.
Further we seem to have extended down time recently:
“There will be a planned outage to the PCEHR Production environment starting at 12 am on 25th May 2013 for system maintenance.
Outage Window: Saturday 25th May 2013 12am – 6pm AEST – PCEHR Consumer Portal
Saturday 25th May 2013 12am – 7am AEST – All other PCEHR Portals/Channels.”
Interestingly there have also been all sorts of issues and problems with the IHI service recently.
One example here:
From: CO_HI_Service
Sent: Thursday, May 23, 2013 4:12 PM
To: CO_HI_Service
Subject: Department of Human Services Advice: Healthcare Identifiers (HI) Service - 22 June 2013 Release Update [SEC=UNCLASSIFIED]
Dear software developer,
On Tuesday, 14 May 2013, the Department of Human Services (the department) advised you of three changes to Healthcare Identifiers (HI) Service technical specifications and WSDLs that would be included as part of the 22 June 2013 release. The department would like to advise you that in response to feedback from a number of HI software vendors, we have revised the release date to implement any WSDL changes to September 2013.  The department will continue to work with software vendors to limit any impacts to their software products.
The 22 June 2013 release will now add additional functionality to the recent release of TECH.SIS.HI.31 and TECH.SIS.HI.32 by providing batch capability through TECH.SIS.HI.33 – Search Provider Individual Batch Asynchronous and TECH.SIS.HI.34 – Search Provider Organisation Batch Asynchronous.
All other clarifications and updates will be outlined in the HI Service – Change Guide June 2013 Release when it is published with the updated draft Licensed Materials shortly.
If you have any questions regarding these updates please contact the HI Vendor Operations team via email hi.vendor.operations@humanservices.gov.au for further information. The department will notify all software developers of any further updates to the 22 June 2013 release.
Online Technical Support Liaison
eHealth and Government to Business Systems Branch
Department of Human Services
----- End E-Mail
Clearly code for ‘we have messed up a bit and need to regroup’.
And success was claimed for an availability of the PCEHR of 98.9% in a recent Senate Estimates Questions on Notice Response from DoHA. The claim was that this was comparable to Hospital systems. (A very badly run one I must say).
This availability implies a full 4 DAYS off line each year! Hardly acceptable for what is claimed to be vital national infrastructure that has cost close to, if not more than, one billion dollars.
All in all we seem to have data errors, system unreliability and, despite recruiters running around everywhere, only limited take up and unproven benefit.
Their effect is documented here:

PCEHR milestones

Personally controlled e-health records:
  • Users (4 March): 73,648
  • Users (22 May): 173,726
  • Average enrolments per day: 3175
  • First 50,000 enrolments: 213 days
  • Second 50,000 enrolments: 60 days
  • Third 50,000 enrolments: 37 days
Source: Department of Health and Ageing
See here:
Still can't see anywhere near the 500,000 target by the end of the month. I wonder how that will all be explained?
Enjoy exploring and do check the contents of your record if you have one. Someone may just misinterpret erroneous data to your profound disadvantage if there is some present!


AJ Jack said...

Evidence that this blog is not a balanced view seems to be building

Anonymous said...

Can you (David) or someone else keep a track of the planned and unplanned outages of each system (eg. IHI, medicare online, patient registration, consumer portal, Health org access etc.).

I think their reliability numbers are based on the average 'unplanned' across several systems instead of the real 'unplanned' + 'planned' outage times when at least one system is not accessible.

---- Tim C

Anonymous said...

Regarding the outcomes of eHealth systems : I don't believe it's all positive but I don't believe it's all negative.

The perceived lack of balance of readership and commentary of this blog may be due to the following. How many of those who think eHealth is all wonderful and should not be criticised actually have their head's in the sand regarding the realities of people, computers, systems and the issues highlighted by this blog. They don't believe in the possibilities of negative outcomes so they don't read or believe this blog. There are many limitations, inconsistencies, risks and costs of eHealth systems that are not discussed when pushing the eHealth band wagon.
The many commentators "AJ Jack" label as being biased are not trying to destroy eHealth but are trying to get action to be taken to improve eHealth systems/funding/implementations/work practices/standards to cause better outcomes.
Ignoring the problems will not make them go away.

---- Tim C

Anonymous said...

And you can be sure that the bandwagon at DOHA and NEHTA use this blog everyday for feedback – they all read it for seriously (and I am sure that it has usefully helped them to avoid some serious problems), and they use it for a laugh.
Yes it is a little biased towards critical – but it provides the much needed balance to the spin.

Dr David More MB PhD FACHI said...

"Can you (David) or someone else keep a track of the planned and unplanned outages of each system (eg. IHI, medicare online, patient registration, consumer portal, Health org access etc.)."

Sorry there is no real source - there should be of course in the name of accountability - where this information can be found.

If anyone knows a source for the information (other than Senate Estimates) please let us know.


Dr David More MB PhD FACHI said...

"Evidence that this blog is not a balanced view seems to be building"

The blog does not seek balance - but it does try to be truthful - whenever I get things wrong the comments soon tell me!

As always if you don't like, don't read! It is free after all.